Heart Yin Deficiency: tired eyes, easily startled

Photo by pina messina on Unsplash

Key Learning Points

  • Not recognised as a disease in Western Medicine, but often seen by doctors
  • Upsets the Mind
  • Has both emotional and physical causes
  • Chinese medicine has some good treatments for it

Heart Yin deficiency arises from various causes – see below – but it wouldn’t happen without there already being Heart Blood deficiency, so please first read up on that.

This syndrome is not recognized in Western Medicine, although its symptoms are familiar to doctors but they call it other things.

The Western medical approach is to use medications to steady the heart-beat and calm the mind.

They then often treat, as separate conditions, many of the symptoms listed below, like insomnia, dizziness and low libido. Individually these could each have a number of different explanations in Chinese medicine. Together, they mean Heart Yin deficiency.

Sometimes Counselling is recommended, but if the patient’s symptoms are actually caused by this syndrome, treating it the Chinese way would work faster.

In turn, this syndrome is the basis for Empty Heat, which accentuates it and adds additional symptoms.

What Causes Heart Yin Deficiency?

You may find some of these causes surprising, because they don’t seem so bad, especially if you are enjoying them! But we know how much children enjoy watching horror movies at midnight, even if the next day they are wretchedly bad company.

What you enjoy, even in a good cause, is still not always ‘good’ for your health. Obviously, the occasional late night does few of us much lasting harm. However, when it becomes a way of life you may get problems.

The longer one of these causes goes on for the more likely it will lead to Heart Yin deficiency.


  • History of emotional problems. For example, sadness, fear, worry or anxiety for years on end.
  • The menopause: this occurs when a woman’s body stops making so much Blood. This can cause Blood deficiency.
  • Always being active or ‘on the go’ or overworking. It seems OK when it’s you, but consider! When it’s you, it’s hard to be objective. In Chinese Medicine, it gradually drains you, weakening Heart Blood, then leading to Heart Yin deficiency. This ‘on the go’ personality is often anxious and unable to let matters rest: everything must be just right before they relax. Of course perfection never actually happens, because they always think of something else that needs to be done!
  • Old people who have experienced any of the above causes. As people age, their bodies become less efficient. For example their Stomach Yang and Spleen Qi reduce, leading to poorer digestion, hence a tendency to Blood deficiency, which can lead to Heart Blood deficiency, then Heart Yin deficiency.
  • After severe over-heating, which is termed an attack by exterior Heat, such as might occur in a fever from an infection or in a very hot country when your body lacks the means to cool itself. The Yin Qi and fluids of your body are consumed by the Yang heat and you get ‘dried out’. Old people and very young children are more susceptible to this.
  • For the same reason, loss of fluids could cause this. This might happen where you get oedema for some reason and take diuretics to clear it before your body really ‘catches up’. Another way might be through heavy loss of lymph fluids through the skin. If your body can’t regenerate these fluids, you may get yin deficiency which could lead on to Heart Yin deficiency.

Symptoms of Heart Yin Deficiency

Mental symptoms common to this condition

  • Anxiety : vague anxiety, an ongoing uneasiness, with a feeling of dullness, somewhat depressed.
  • Always tired, or tired after even mild exertion, worsening in the afternoon and especially towards evening. This tiredness is partly caused by poor sleep – see below.
  • Mentally restless: poor concentration and poor memory.
  • Easily startled. The Heart houses the Mind. When Heart Blood and Yin are deficient, there’s no solid house for the Mind, which is easily ‘shaken’. 
  • As with many deficient Yin syndromes, the syndrome is often worse as the day progresses or in the evening.

Physical Symptoms Common to Heart Yin Deficiency

  • Palpitations: the heart suddenly races, causing great anxiety. (Actually, this may not be as serious as it seems, if it occurs only occasionally in healthy people. However, if frequent, it becomes debilitating.)
  • Insomnia. Apart from difficulty getting to sleep, you may wake during the night, sometimes from night sweats. Sleep is disturbed by many dreams.
  • Dizziness: sometimes with very short, transient episodes of fainting or mental blackouts, as if you can’t remember what happened. For example, you walk along a short corridor, and can’t remember how you reached the end of it. Alternatively you faint, but don’t lose consciousness. 
  • Heat: not so much a sensation of real heat radiating from you, more feeling somewhat ‘hot and bothered’. Later in the day, you feel warmer and your tongue itches or burns, your ears feel hot.  (Actually that is more due to Kidney Yin deficiency, but it often contributes to Heart Yin deficiency symptoms).
  • Warm hands and feet: specifically it is more likely to be your palms and soles that feel warm, and this increases through the day, occurring more in the evening, by when your palms may also be sweating. In the morning, you could even have cold hands.
  • Warm Chest: as with your palms and soles, the centre of your chest may feel warm, more so towards the evening.
  • Pain: in itself this syndrome doesn’t have much pain, more uneasiness and heat, but sometimes there is pain, occurring later in the day or evening, and affecting the palms, eyes or tongue

Those are the main symptoms, but there are others!

  • Complexion: usually dull or pale, but often with surprisingly pink cheek bones in the afternoon or evening.
  • Eyes: eyes may be dry. 
  • Low libido: the anxiety, depression and heat, and sometimes dryness, take the pleasure out of sex. (Technically, the Blood deficiency which underlies Heart Yin deficiency prevents satisfactory engorgement for both sexes, reduces the lubricating fluids and, more importantly, undermines confidence and desire.)
  • Breast Milk may be scanty, Less Blood, less breast milk, but also the Yin deficiency contributes not just to lack of confidence and depression, but to a state of mind that is impatient with the whole thing. 
  • Fertility, Periods, Post-natal Depression: Blood deficiency can cause periods to be sparse, tending to a complete lack of periods (amenorrhoea), infertility or, after childbirth, post-natal depression. (Chinese medicine can usually help post-natal depression because it can explain it in terms of Chinese medical syndromes, for instance like this one – Heart Yin deficiency.) 
  • Mouth and Throat: dryness, hence thirst, see below. 
  • Thirst: with Yin deficiency syndromes, the thirst is different from Yang excess syndromes where you want to gulp down fluids, preferably ice-cold. With Heart Yin deficiency, and other Yin deficiency syndromes, you tend to want just to take occasional drinks, or lots of small sips. Also, you probably don’t want the fluid to be too cold: a little cold fluid goes a long way. (You may even prefer the fluid to be warm, which is better for you, at least from the perspective of Chinese medicine, because warm fluids impose less of a strain on the Stomach Yang energy.) However, sometimes you’ll find Yin deficiency people liking to suck a small piece of ice, but this tends to occur more when we look at Heart Yin deficiency with Empty Heat.

Tongue and Pulse with Heart Yin deficiency

  • Tongue: usually the tongue is normal colour but has no tongue coating. If there is a tongue coating it will be ‘rootless’, (a technical term meaning that the coating looks as if it has been applied to the surface of the tongue and could just as easily be wiped off. A normal tongue coating is more closely attached to the surface of the tongue and quite hard to remove, if not impossible.)
  • Pulse: the normal pulse for Heart Yin deficiency is ‘floating’ and ’empty’. Floating means that it can be felt near the surface of the skin but not on deeper pressure. Empty means that as you press it may seem quite a big strong pulse but on further pressure it suddenly disappears, like pressing on the stalk of an onion: there’s nothing underneath.
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Treatment of Heart Yin Deficiency

Because with Heart Yin deficiency there are other, underlying, syndromes such as Heart Blood deficiency, other factors may need to be treated. (Such as? Stomach and Spleen qi for Blood, and Kidney Yin to support Yin deficiency.) In so far as we look at Heart Yin deficiency just in itself, the aim is to calm the Mind, and to tonify Heart Yin.

Points that tonify Heart Yin include Yinxi, HE-6 and Shenmen, HE-7. Also useful are Neiguan P-6 and Juque Ren-14 and Jiuwei Ren-15. Sanyinjiao Sp-6, Baihui Du-20 also have calming effects, the former by tonifying Blood and Yin, the latter by sending uprising Qi downwards.

For other Heart syndromes, click below.

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